UNITEK LVN DEMENTIA AND LOSSES
EXAM STUDY GUIDE PRACTICE QUESTIONS
AND COMPLETE SOLUTIONS GRADED A+
⩥ water distribution in body compartments.
Answer: ...
⩥ glomerular filtration barrier components.
Answer: Fenestrated capillary endothelium (size barrier)
Fused basement membrane with heparan sulfate
(negative charge barrier)
Epithelial layer consisting of podocyte foot processes
THE BASEMENT MEMBRANE LAYER IS LOST IN NEPHROTIC
SYNDROME - LOST CHARGE BARRIER --> albuminuria,
hypoproteinemia, generalized edema, and hyperlipidemia
BM = type IV collagen, made by visceral
epithelial/podocyte
⩥ renal clearance + GFR.
Answer: CL = UV/P
in mL/min
,NL ~ 100 mL/min
creatinine moderately overestimates GFR
(some secretion)
inulin accurately measures GFR
in pregnancy and early diabetic nephropathy -->
INCR in Cr CL
in elderly and acute/chronic renal dz -->
DECR in Cr CL
⩥ effective renal plasma flow (ERPF).
Answer: CL = UV/P
use PAH as proxy
ERPF can be estimated using PAH CLEARANCE bc it is both
FILTERED and actively SECRETED (CARRIER MEDIATED
TRANSPORT) in the proximal tubule + ALL PAH entering the kidney is
EXCRETED
--> typically underestimates renal plasma flow by 10%
RBF = RPF/(1 - Hct)
,⩥ filtration fraction + load.
Answer: FF = GFR/RPF
NL ~ 20%
filtered load = GFR x plasma concentration
⩥ modulators of afferent + efferent arteriole.
Answer: ...
⩥ effect of plasma protein concentration on GFR, FF.
Answer: incr [plasma] = decr GFR, decr FF
decr [plasma] = incr GFR, incr FF
⩥ reabsorption + secretion calcs.
Answer: excretion rate = U x V
filtered load = GFR x [plasma]
reabsorption = filtered - excreted
secretion = excreted - filtered
, ⩥ glucose clearance.
Answer: AT NORMAL PLASMA CONCENTRATIONS GLUCOSE IS
COMPLETELY REABSORBED IN PROXIMAL TUBULE BY
Na/glucose COTRANSPORT
DIABETES (~>160) --> GLUCOSURIA
all transporters fully saturated at 350
⩥ AA clearance.
Answer: Na mediated transport in PROXIMAL TUBLE
COMPETITIVE INHIBITION between AAs
--> PROTEINURIA when overloaded
HARTNUPs DZ = NEUTRAL AA TRANSPORTER DEFICIENCY -
TRYPTOPHAN TRANSPORTER in kidney
--> CANT RESORB NEUTRAL AA's - TRYPTOPHAN
--> CANT MAKE 5HT, MELATONIN, NIACIN/NAD+
TRYPTOPHAN DEFICIENCY --> PELLAGRA
⩥ membrane channels in proximal tubule.
Answer: Early proximal tubule - contains brush border
EXAM STUDY GUIDE PRACTICE QUESTIONS
AND COMPLETE SOLUTIONS GRADED A+
⩥ water distribution in body compartments.
Answer: ...
⩥ glomerular filtration barrier components.
Answer: Fenestrated capillary endothelium (size barrier)
Fused basement membrane with heparan sulfate
(negative charge barrier)
Epithelial layer consisting of podocyte foot processes
THE BASEMENT MEMBRANE LAYER IS LOST IN NEPHROTIC
SYNDROME - LOST CHARGE BARRIER --> albuminuria,
hypoproteinemia, generalized edema, and hyperlipidemia
BM = type IV collagen, made by visceral
epithelial/podocyte
⩥ renal clearance + GFR.
Answer: CL = UV/P
in mL/min
,NL ~ 100 mL/min
creatinine moderately overestimates GFR
(some secretion)
inulin accurately measures GFR
in pregnancy and early diabetic nephropathy -->
INCR in Cr CL
in elderly and acute/chronic renal dz -->
DECR in Cr CL
⩥ effective renal plasma flow (ERPF).
Answer: CL = UV/P
use PAH as proxy
ERPF can be estimated using PAH CLEARANCE bc it is both
FILTERED and actively SECRETED (CARRIER MEDIATED
TRANSPORT) in the proximal tubule + ALL PAH entering the kidney is
EXCRETED
--> typically underestimates renal plasma flow by 10%
RBF = RPF/(1 - Hct)
,⩥ filtration fraction + load.
Answer: FF = GFR/RPF
NL ~ 20%
filtered load = GFR x plasma concentration
⩥ modulators of afferent + efferent arteriole.
Answer: ...
⩥ effect of plasma protein concentration on GFR, FF.
Answer: incr [plasma] = decr GFR, decr FF
decr [plasma] = incr GFR, incr FF
⩥ reabsorption + secretion calcs.
Answer: excretion rate = U x V
filtered load = GFR x [plasma]
reabsorption = filtered - excreted
secretion = excreted - filtered
, ⩥ glucose clearance.
Answer: AT NORMAL PLASMA CONCENTRATIONS GLUCOSE IS
COMPLETELY REABSORBED IN PROXIMAL TUBULE BY
Na/glucose COTRANSPORT
DIABETES (~>160) --> GLUCOSURIA
all transporters fully saturated at 350
⩥ AA clearance.
Answer: Na mediated transport in PROXIMAL TUBLE
COMPETITIVE INHIBITION between AAs
--> PROTEINURIA when overloaded
HARTNUPs DZ = NEUTRAL AA TRANSPORTER DEFICIENCY -
TRYPTOPHAN TRANSPORTER in kidney
--> CANT RESORB NEUTRAL AA's - TRYPTOPHAN
--> CANT MAKE 5HT, MELATONIN, NIACIN/NAD+
TRYPTOPHAN DEFICIENCY --> PELLAGRA
⩥ membrane channels in proximal tubule.
Answer: Early proximal tubule - contains brush border
